Lipid Screening in Children and Adolescents in Community Practice: 2007 to 2010
Autor: | Emily D. Parker, Heather M. Tavel, Nicole K. Trower, Alan R. Sinaiko, Joan C. Lo, David J. Magid, Stephen R. Daniels, Elyse O. Kharbanda, Patrick J. O'Connor, Louise C. Greenspan, Karen L. Margolis, Malini Chandra, Matthew F. Daley |
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Rok vydání: | 2014 |
Předmět: |
Male
Pediatrics medicine.medical_specialty Percentile Adolescent Overweight Article Young Adult medicine Humans Mass Screening Young adult Child Triglycerides Mass screening Dyslipidemias business.industry Cholesterol HDL Cholesterol LDL Odds ratio medicine.disease United States Child Preschool Practice Guidelines as Topic Population study Female medicine.symptom Cardiology and Cardiovascular Medicine business Body mass index Social Welfare Dyslipidemia |
Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 7:718-726 |
ISSN: | 1941-7705 1941-7713 |
DOI: | 10.1161/circoutcomes.114.000842 |
Popis: | Background— Integrated guidelines on cardiovascular health and risk reduction in children issued in 2011 newly recommended universal screening for dyslipidemia in children at 9 to 11 years and 17 to 21 years. Methods and Results— We determined the frequency and results of lipid testing in 301 080 children and adolescents aged 3 to 19 enrolled in 3 large US health systems in 2007 to 2010 before the 2011 guidelines were issued. Overall, 9.8% of the study population was tested for lipids. The proportion tested varied by body mass index percentile (5.9% of normal weight, 10.8% of overweight, and 26.9% of obese children) and age (8.9% of 9- to 11-year olds and 24.3% of 17- to 19-year olds). In normal weight individuals, 2.8% of 9- to 11-year olds and 22.0% of 17- to 19-year olds were tested. In multivariable models, age and body mass index category remained strongly associated with lipid testing. Sex, race, ethnicity, and blood pressure were weakly associated with testing. Abnormal lipid levels were found in 8.6% for total cholesterol, 22.5% for high-density lipoprotein-cholesterol, 12.0% for non–high-density lipoprotein-cholesterol, 8.0% for low-density lipoprotein-cholesterol, and 21% for triglycerides (age, 10–19 years). There was a strong and graded association of abnormal lipid levels with body mass index, particularly for high-density lipoprotein-cholesterol and triglycerides (2- to 6-fold higher odds ratio in obese when compared with that in normal weight children). Conclusions— Lipid screening was uncommon in 9- to 11-year olds and was performed in a minority of 17- to 19-year olds during 2007 to 2010. These data serve as a benchmark for assessing change in practice patterns after the new recommendations for pediatric lipid screening and management. |
Databáze: | OpenAIRE |
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